Pathophysiology and Risk Factors of Diabetes

Diabetes mellitus (DM) is a group of metabolic disorders that share factors contributing to hyperglycemia including reduced insulin secretion, decreased glucose utilization, and increased glucose production. Many pathways driven by various genetic and environmental factors result in progressive loss of beta cell mass and function, leading to hyperglycemia. Patients with hyperglycemia are predisposed to risk for complications, including cardiovascular diseases, end-stage renal disease (ESRD), non-traumatic lower extremity amputation, and adult blindness. In 2015, a research symposium titled “The Differentiation of Diabetes by Pathophysiology, Natural History and Prognosis” was held by the American Diabetes Association (ADA), Juvenile Diabetes Research Foundation (JDRF), European Association for the Study of Diabetes, and American Association of Clinical Endocrinologists. International experts in various fields, including genetics, immunology, metabolism, endocrinology, and systems biology, overviewed type 1 and type 2 DM, particularly genetic and environmental determinants, risk, progression, and complications. Understanding the pathophysiology of DM and identifying individuals at high risk will help develop appropriate therapeutic approaches.